September 25, 2016, 11:47 am

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I am sitting here in Starbucks for the first time in months – I can’t even remember the last time I blogged over coffee – and their microwave kept alarming. Motilium 10mg pills $240.00 I got out of my chair to go check the alarm!

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Motilium 10mg pills $240.00 Ah, motilium 10mg pills $240.00 but there is a silver lining on the horizon!

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Motilium 10mg pills $240.00 The ENA always puts on stunning programs – literally “attend today, motilium 10mg pills $240.00 use in practice tomorrow” information. Motilium 10mg pills $240.00 You don’t have to be a manager to attend the Leadership Conference, motilium 10mg pills $240.00 either. Motilium 10mg pills $240.00 All nurses are leaders, motilium 10mg pills $240.00 and there is more than enough in this conference for every nurse, motilium 10mg pills $240.00 from newbie to veteran.

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The department is chaotic.

Every bed full.

The hallways are impacted.

With patients. Motilium 10mg pills $240.00 Family members. Motilium 10mg pills $240.00 Lab techs. Motilium 10mg pills $240.00 Portable xray machines and those who wield them.

Three ambulances waiting to give report.

Administrators.

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Surgeons.

Who want everything….STAT.

Even though nothing about their patients require STAT.

Somewhere in there is the ER physician. Motilium 10mg pills $240.00 And the PA.

We’re on divert, motilium 10mg pills $240.00 except no one told the three ambulances.

Waiting.

No place to sit.

No place to chart.

No place to stand.

*****

And in the middle of all this…

In the middle of this bedlam.

Comes the order.

To give the first dose all the prescribed medications to the ambulatory, motilium 10mg pills $240.00 playing, motilium 10mg pills $240.00 giggling child with otitis media, motilium 10mg pills $240.00 who is with a totally ambulatory, motilium 10mg pills $240.00 fully functional, motilium 10mg pills $240.00 totally-capable-of-going-to-the-pharmacy-and-starting-the-medication-at-home adult parent.

So what, motilium 10mg pills $240.00 you say?

Well, motilium 10mg pills $240.00 this means that instead of being able to discharge this ambulatory, motilium 10mg pills $240.00 capable parent with discharge instructions and a prescription right then and there, motilium 10mg pills $240.00 the RN must now engage in the preparation and administration of a pediatric medication.

Which means:

  • Going to the Pyxis and removing the medications, motilium 10mg pills $240.00 say Tylenol and Zithromax, motilium 10mg pills $240.00 from the machine.
  • Because the Hilton Hospital has no Pharmacy at night, motilium 10mg pills $240.00 the Zithromax must be reconstituted by the RN – yep, motilium 10mg pills $240.00 we measure it, motilium 10mg pills $240.00 we mix it, motilium 10mg pills $240.00 we shake it, motilium 10mg pills $240.00 we pour it.
  • Calculating the appropriate dose based on the child’s weight (yes, motilium 10mg pills $240.00 we have to do that, motilium 10mg pills $240.00 even if the doctor has written a dose).
  • Pour the meds, motilium 10mg pills $240.00 draw them up into a dosing syringe.

Motilium 10mg pills $240.00 No biggie so far? Remember all the hell going on in the rest of the department? One nurse is tied up doing this totally unnecessary function. Motilium 10mg pills $240.00 But it gets better because…

Motilium 10mg pills $240.00 They have decided that decades of nursing experience is not enough to ensure appropriate safeguards in pediatric medication administration so…

  • A second nurse has to calculate and double check everything the first nurse has done and sign off on the calculations before the medication is given.

Motilium 10mg pills $240.00 And there you have it! Two nurses taken from much more critical work to make sure ambulatory, motilium 10mg pills $240.00 playing, motilium 10mg pills $240.00 giggling child with otitis media gets their first dose of medication, motilium 10mg pills $240.00 when there is no reason on God’s green earth Mommy and Daddy cannot go get the medication and start it themselves.

Motilium 10mg pills $240.00 And why?

Motilium 10mg pills $240.00 Because it all has to do with patient satisfaction!

If we don’t do this, motilium 10mg pills $240.00 they don’t think we treated their child. Motilium 10mg pills $240.00 And gosh, motilium 10mg pills $240.00 it’s the middle of the night and who wants to wait with a tired kid at the pharmacy and what if the pharmacist is on break and what if they don’t have the cash and what if the ATM machine is broken and…..

EEEEEEEEEEEENOUGH!!!!!!!!

Seriously, motilium 10mg pills $240.00 people, motilium 10mg pills $240.00 this is the minutiae that we have to deal with.

I want to take good care of my patients, motilium 10mg pills $240.00 I really do. Motilium 10mg pills $240.00 I like my patients, motilium 10mg pills $240.00 I want to make their stay in the ER easier and more comfortable and as pain free as I can possibly make it.

I’m a good nurse. Motilium 10mg pills $240.00 No. Motilium 10mg pills $240.00 I’m a damn, motilium 10mg pills $240.00 excellent nurse.

But this bullshit is killing me.

Killing me.

Oh, motilium 10mg pills $240.00 and someday, motilium 10mg pills $240.00 let’s go out and have a drink and I’ll tell you about the time I got the order to irrigate my patient’s ears. Motilium 10mg pills $240.00 In fact, motilium 10mg pills $240.00 it was on the same night. Motilium 10mg pills $240.00 She was having a bit of trouble hearing, motilium 10mg pills $240.00 you see. Motilium 10mg pills $240.00 Berated me because I wasn’t doing it fast enough. Motilium 10mg pills $240.00 She didn’t care that hypotension and a cath lab patient trumped ear wax.

Yeah, motilium 10mg pills $240.00 I definitely need a margarita to tell that one…..

Average Rating: 4.4 out of 5 based on 243 user reviews.

3 Comments

  • deedoyle
    deedoyle

    February 4, 2011 at 3:33 am

    The trials of the ER nurse, and any urgent care nurse are many. My sympathy and empathy to those who trudge daily through the maze to give the best possible patient care possible.
    Dr. Pamela Wible speaks on community-based patient-centered care at the One Path Summit in Atlanta this March 26-27. Along with 7 of her peers, Dr. Wible will join in discussions on traditional and complementary medical practices.
    For more info go to http://www.onepathsummit.com.


  • John
    John

    February 4, 2011 at 4:57 am

    Oh , My sympathy is with you. Don’t feel low. I’m sure you will get something to learn from such kind of experiences too


  • TD
    TD

    February 4, 2011 at 3:23 pm

    As an ER doc, I totally share your frustration. Our job is not to make patients happy. Our job is to make them better.

    If they wind up happy because we’ve made them better, then that is great. However, patient satisfaction is not my goal. My goal is to provide good care.

    Unfortunately, patient satisfaction is becoming more and more of a forced issue. Many ER groups are starting to use patient satisfaction ratings as a factor in determining the physicians’ pay.

    Talk about a conflict of interests!

    myerlife.com


About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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